Yes, you do. The lifetime risk of colorectal cancer is 6%. Let’s first assume you have no symptoms, are < 50 years old, and have no family history... you do not need a screening colonoscopy. If you are over 50 you need one. This is true whether or not you have symptoms and whether or not your annual stool test is negative, and that is the standard of care. I know a colonoscopy is no small deal but you may be convinced to have one when I show you why.
The average risk population needs their first screening colonoscopy at age 50. If you have a family history you will get yours either at age 50, or 10 years prior to your family members' diagnosis (so if your father was 48 when he was diagnosed you get one at 38).
Sub-standard colon cancer screening is still practiced in some areas. An annual fecal occult blood test (where a sample of stool is placed on a card and a liquid solution is added to see if it turns blue indicating microscopic blood in the stool) & flexible sigmoidoscopy every 3-5 years is still done in some areas. Flexible sigmoidoscopy is an easier procedure because it can be done in the office without the sedation they use for colonoscopy, yet it can view only the lower third of the colon. Why do I want my patients to undergo a procedure where I can tell them this: “well, the lower third of your colon looks great.” Hmmmm, and the rest?
For your screening colonoscopy you need to find a gastroenterologist who performs them all the time. The colon preparation the day before is truly a bummer as you will be pooping water by the end of the night. You will receive twilight anesthesia not general anesthesia and won’t remember much of anything.
What about the virtual colonoscopy (CT colonography)? This is a CT scan with radiation used to image the colon where a colon preparation/cleanse is still involved. Virtual colonoscopy is not yet recommended as a screening tool because of the cost, and the fact that if a colon polyp is seen, you will still have to have a colonoscopy for removal. Compare this to your gastroenterologist seeing a polyp during your colonoscopy and removing it right there. One procedure.
Colon cancer deaths dropped for the first time 4 years ago and that is because of screening colonoscopy. This will amaze you; look how it compares in cost per year of lives saved to other screening procedures:
Colonoscopy every 10 years: $6,600
Breast cancer screening: $22,000
Heart transplantation: $160,000
Cervical cancer screening: $250,000
Convinced? Embrace the colon- cleanse you have to do prior to your procedure because when you find out your colonoscopy is normal, you are in the clear for 10 years.